Spontaneous remission of acute myeloid leukemia in children. Case series and literature review

Acute myeloid leukemia (AML) is a heterogeneous group of hematopoietic malignant neoplasms, the substrate of which is the clonal proliferation of myelopoiesis progenitor cells. The key AML features are uncontrolled proliferation and arrest of cell differentiation, which leads to specific damage of various organs and systems; in the absence of specific therapy, death occurs quite quickly.Spontaneous AML remission is considered a rare phenomenon. In 1878, the first mention of AML clinical manifestations regression after acute infectious disease was made, but the remission was short and a relapse soon occurred.The article presents a literature review and 3 clinical cases, systematizing information on known cases of spontaneous AML remission in children. Attention is focused on various mechanisms that may contribute to spontaneous AML remission in children. These may be either immune-mediated reactions to leukemic cells or the influence of infectious agents, which in some cases activate antitumor immunity. In some cases, a direct correlation is observed between the presence of infectious processes and a decrease of tumor cells number, which emphasizes the importance of further studying the molecular mechanisms of interaction between immune and tumor cells.There is no evidence of a correlation between age and spontaneous remission. Spontaneous remission, although rare, may be a significant factor to consider when planning a treatment strategy.Further clinical studies are needed to better understand the spontaneous remission mechanisms in childhood AML. This may lead to improved treatment results and increased chances of a favorable outcome for patients.